A committee that’s been attacked for its controversial mammogram recommendations for half a decade clarified that advice Monday, saying they have been misunderstood.
The panel says women in their 40s can get mammograms every year if they want to, but said it really needs to be up to a woman to decide if she wants to risk the anxiety of getting a false positive result — one showing a breast lump that turns out not to be cancer, after all.
So the recommendations remain the same — women over 50 should get a mammogram every other year. Women 40 to 49 should decide what they want, based on their health history, and it’s not clear if women over 75 should bother with mammograms.
“The science shows that some women in their 40s will benefit from mammography, most will not, while others will be harmed,” the U.S. Preventive Services Task Force (USPSTF) says in its updated mammography recommendations.
"The most common harm is a false-positive test result, which often leads to additional tests and procedures."
“Of the potential harms, the most serious is unneeded diagnosis and treatment for a type of breast cancer that would not have become a threat to a woman’s health during her lifetime. The most common harm is a false-positive test result, which often leads to additional tests and procedures. While some women do not mind the anxiety that accompanies a false-positive mammogram, other women consider this a harm.”
The group notes that women over 40 who have a mother, sister, or daughter with breast cancer may benefit more than average by getting early screening.
The recommendations are important because the 2010 Affordable Care Act requires health insurers to pay for screening procedures that the group recommends strongly. But mammograms have become an exception, because many doctors and groups like the American Cancer Society tell women to get annual mammograms starting at age 40.
Dr. Michael LeFevre, immediate past chair of the Task Force and a family medicine expert at the University of Missouri, says the group wants to clarify its advice.
“After the 2009 breast cancer screening recommendation was published, it immediately became clear that our recommendation for women in their 40s was interpreted by many as a recommendation against mammography for anyone in their 40s,” LeFevre said in a statement.
“In fact, we intended it to be a recommendation in favor of empowering women with the knowledge to help them make an informed choice.”
But the clarification has not made critics happy. The American College of Radiology, which represents the experts who interpret mammograms, says it’s not helping matters.
“Adoption of draft United States Preventive Services Task Force (USPSTF) breast cancer screening recommendations would result in thousands of additional and unnecessary breast cancer deaths each year,” the group said in a statement.
“Thousands more women would experience more extensive and expensive treatments than if their cancers were found early by a regular mammogram.”
In reality, most insurance companies do cover mammograms recommended by a doctor, however.
"It immediately became clear that our recommendation for women in their 40s was interpreted by many as a recommendation against mammography for anyone in their 40s.”
Several studies have suggested that routine mammograms don’t necessarily save women’s lives, even if they detect breast cancer earlier.
And at least one study has showed that many women suffer intense anguish after they get called for a follow-up mammogram when a radiologist has spotted something suspicious.
Breast cancer is a leading killer of U.S. women. Every year, it's diagnosed in 200,000 women and a few men, and kills around 40,000.
The USPSTF also looked at 3-D mammography and said there isn’t enough evidence yet to say whether it should be recommended. And it said while it’s known that women with dense breasts have a higher risk of breast cancer, it’s not clear if doing more frequent mammograms would help them.